Archived: Green Lane

Green Lane is a care home without nursing providing accommodation and personal care to 14 adults at the time of the inspection. The service can support up to 15 people. People who live in the home all have a diagnosis of a mental health condition. The home is an adapted building which includes three self-contained flats.

People’s experience of using this service and what we found

People were not always kept safe from the risk of infection. Cleaning schedules were not followed and updated consistently. This caused confusion as to what cleaning responsibilities had been completed.

People were not always supported with meaningful activities that were suited to their hobbies and preferences. We have made a recommendation in relation to this.

There was no registered manager in post at the home. This meant various day to day management responsibilities were not consistently completed.

Risks were assessed and reviewed and guidance was available for staff to follow to keep people safe. People were supported with their medicines by staff that had received relevant training.

Staff were recruited in a safe way and were up to date with all relevant training. Staff felt supported by the temporary management team.

People told us that staff were kind and caring and supported them to access social and health care professionals. Accidents and incidents were recorded, analysed and action taken to ensure preventative measures were put in place.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 28 February 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, not enough improvement had been made and the provider was still in breach of regulations. The service remains requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by our data insight that assesses potential risks at services, concerns raised and based on the previous rating. This enabled us to review the previous ratings.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Green Lane is a care home providing personal care for to up to 15 people who may be living with a mental health condition. At the time of inspection, the service was supporting 12 people. The home accommodates people in one main building set on two floors and three flats in the grounds of the home.

People’s experience of using this service and what we found

The service was not consistently safe. People’s risks were assessed; however, assessments were not always accurate and management plans were not always in place or followed. There were not always enough staff to keep people safe. Infection control measures needed to be improved and medicines were not always managed safely.

Quality assurance measures in place were not sufficient to identify quality or safety issues including those highlighted in this report related to risk management, staffing levels, recruitment and training.

We received mixed feedback with regards to how supported staff felt in the service. People were supported and encouraged to engage in the service and community. Staff worked with other agencies to meet people’s needs.

Staff received mandatory training and inductions, however, staff had not always received training in specialist areas that would have helped to meet people’s needs more effectively. Staff told us that due to lack of staff that they were restricted to be able to attend training they felt would benefit them in their role.

People were supported to have maximum choice and control, however decisions made when they lacked capacity were not always evidenced. It was therefore unclear if these decisions were in their best interest or the least restrictive. Policies and systems were in place; however, these were not always followed.

People’s care and support needs were assessed. There was some inconstancy of information and detail in support plans and these were not always person-centred. The registered manager had identified this and was in the process of making changes to peoples care files.

Care workers had developed relationships with people they supported. Staff respected people's dignity and privacy and promoted their independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing levels, good governance and safe recruitment at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Green Lane is a care home registered to provide accommodation and care for up to 15 people. At the time of our inspection there were 11 people living at the home. Green Lane provides long term support to people living with various mental health conditions. They also provide temporary support to people during periods of crisis.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our last inspection was in November 2015 where we identified concerns with risk assessments, infection control, premises safety, medicines management, staffing, care plans, consent and governance. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

The home environment was clean and systems were in place to maintain cleanliness as well as the environment. People were supported to maintain their home environment and were involved in decisions about the home.

There were sufficient staff present to meet people’s needs. People were safe and staff were able to spend time with people developing their daily living skills. The provider undertook checks to ensure staff were suitable. Staff had access to a wide range of training to support them in their roles.

Staff understood their roles in protecting people from abuse and acted appropriately where safeguarding concerns were identified. Risks to people were routinely assessed and where incidents had occurred, actions were taken to prevent a reoccurrence. Staff were trained in managing medicines, which they administered safely.

People’s rights were protected as staff had an understanding of current legislation. Staff understood the Mental Capacity Act (2005) and we saw examples of staff supporting people who were subject to conditions under the Mental Health Act (1983). People were able to access the local community freely.

People were supported by caring staff who supported them to make choices and develop independence. People made choices about activities they took part in. People’s dietary needs were met and people were supported to develop skills in managing their own nutrition. People had access to healthcare professionals and staff worked alongside them to meet people’s needs.

Staff knew the people they supported well and had built positive relationships with them. Staff promoted people’s privacy and dignity when providing support. Staff had access to person-centred care plans which highlighted what was important to people. People’s needs were regularly reviewed in order to identify any changes.

Systems were in place to measure the quality of the care that people received. The provider took action where they identified improvements. People and relatives provided feedback, which the provider acted upon. Staff responded to complaints. Staff felt supported by management and had input into how the home was run.

13 people were using the service and present at the outset of the visit. Two people later left the home to engage in community activities. We saw a group activity in progress. This was an interactive, stimulating session. People had been encouraged to contribute suggestions for a new social and educational activities programme.

We spoke with two people in some depth and more briefly with four others. People said that overall they were satisfied with arrangements for meeting their needs. They had been consulted and had agreed individual personal support and care objectives. Their comments included, 'Staff are okay, there is nothing wrong with the home' and ' I feel very positive about my admission here, it has given me time to rest'.

Risk assessment and risk management activities ensured the safety and security of the environment. Emergency procedures were in place. People told us that they had no complaints. There were systems for responding to concerns and complaints.

We observed that there was a very relaxed atmosphere at the home. We saw that staff were communicating with people using the service in a calm manner and in a way that they could understand. We also saw that people were being supported to live independently. For example, everybody had their own fridge and cupboard which had their name on and a key for the lock. People using the service were also supported to manage their finances and their own food budget.

We observed that staff were interacting with people and provided active support when it was requested. For example, we saw a staff member assist with cooking. We also saw a staff member sitting and talking to a person who was upset. We spoke to the manager about their audit process. We saw that the quality of the service had been monitored on a regular basis. This had been done by staff, service user and relative surveys. We saw that an action plan had been produced as a result of their findings.